The purpose of this program is to develop the organizational structure that will support the activities of a multidisciplinary regional Center devoted to the study of the mechanisms, diagnosis and treatment of chronic or persistent pain conditions of deep tissues and those associated with nerve injury. A primary focus will be on orofacial pain conditions of such origin and their comparison with similar pain conditions existing in other regions of the body. The program will be diverse and span the basic and clinical sciences and clinical management from molecular studies to clinical trial studies to outreach and demonstration projects in the community. We are fortunate that major expertise in these areas exists in the Baltimore area at the University of Maryland at Baltimore and at Johns Hopkins University. We have also sought out colleagues in surrounding regions with unique qualifications to join us in this exciting endeavor. Our working model is that research on pain has reached a level of understanding that facilitates the transfer of basic knowledge to the study of persistent pain in humans, and ultimately to new methods of diagnosing and treating these conditions in the general population. Further advances will require multidisciplinary collaborations among basic and clinical scientists and clinicians. A multidisciplinary Center in the thematic area of persistent pain will facilitate this collaboration and interaction and hopefully lead to improved management of orofacial pain and oral health. The specific aims of the Center will be: 1) To elucidate the neural basis, psychosocial influences, and proper treatment of temporomandibular disorders (TMD) and other orofacial pains. 2) To elucidate biological and psychosocial factors that predict the occurrence of chronic or persistent pain following acute back injury. 3) To elucidate the mechanisms of visceral pain and the differences and interaction between visceral and cutaneous pain. 4) To further elucidate the underlying basic peripheral and central nervous system mechanisms associated with persistent pain of nerve injury in animal models and to translate these findings rapidly into the development of new treatment approaches. 5) To transfer these research findings: a) to health professionals and the public with an emphasis on research methods for educating health professionals including demonstration projects and b) to community outreach programs with a focus on disadvantaged populations. A sub-aim will be to transfer technology advances from the research arena to clinical management and elsewhere.